Citation Nr: 21024639 Decision Date: 04/23/21 Archive Date: 04/23/21 DOCKET NO. 17-28 819 DATE: April 23, 2021 REMANDED An initial compensable rating for distal tuft fracture, distal third finger, left hand. An initial compensable rating for distal tuft fracture, distal fourth finger, left hand. Service connection for plantar fasciitis. Service connection for an gastrointestinal (GI) disorder. Service connection for a left knee disorder. Service connection for a right knee disorder. Service connection for a neck disorder. Service connection for a left elbow disorder. Service connection for a right elbow disorder. Service connection for a bilateral hernia. Service connection for erectile dysfunction (ED). Service connection for a traumatic brain injury (TBI). Service connection for headaches. REASONS FOR REMAND The Veteran served on active duty from November 1989 to November 1993, from March to June 1995, from August 2002 to July 2003, from June 2008 to July 2009, and from April to November 2013, with service in the Southwest Asia Theater of Operations. In connection with this appeal, he testified before the undersigned Veterans Law Judge (VLJ) in January 2021. A copy of the transcript has been associated with the record. At his January 2021 Board hearing, the Veteran testified that he had been receiving current and consistent treatment at the Dallas, Plano, and Fort Worth VA Medical Centers (VAMC) and that several of his VA and private treatment providers had linked his current disorders with his duty. With respect to all the appeals, the record does not contain any medical records from the Plano VAMC, and the most recent treatment records from Dallas or Fort Worth are from 2016. Thus, updated treatment records need to be associated with the claims file. With respect to the fractured fingers specifically, the Veteran testified that he had imaging done at the Fort Worth VAMC and that the examiner told him his bones were fully exposed. He also noted that he was having trouble moving his fingers. The last VA examination was in February 2016. Given his current complaints, an updated examination is needed. With respect to plantar fasciitis, the service treatment records (STRs) reflect multiple instance of heel pain, calcaneal spurs, and a notation of plantar fasciitis. A May 2015 examiner opined it was less likely than not that plantar fasciitis was related to the single instance of calcaneal spurs in service. The examiner, however, did not consider or address the Veteran’s in-service complaints of heel pain, the notations of plantar fasciitis during service, or the of the Veteran’s post-service treatment records, and only considered the notation of a calcaneal spur. As such, an addendum opinion is needed to adjudicate the appeal. With respect to a GI disorder, post-service treatment reflects a diagnosis of gastroesophageal reflux disease (GERD) and STRs reflect treatment for an esophageal food compaction issue in July 2013. Despite numerous indications of GERD in the treatment records, the July 2015 VA examiner found no diagnosis and thus, no opinion was rendered. As the record suggests ongoing complaints related to GERD, another medical opinion is needed. Finally, the Veteran has repeatedly asserted that ED was secondary to service-connected posttraumatic stress disorder (PTSD). While his treatment records show a diagnosis of ED and he is service connected for PTSD, no medical opinion has been obtained to assess the etiology of ED. Thus, a medical opinion is needed. The matters are REMANDED for the following actions: 1. Identify and obtain any outstanding, pertinent, VA and private treatment records and associate them with the claims file. Special attention should be made to obtain updated records from the Dallas, Fort Worth, and Plano VAMCs. The Veteran should also be properly notified and afforded the opportunity to submit any relevant private treatment records. 2. Schedule the Veteran for an examination to assess the current status of the finger disabilities. The claims file should be made available to the examiner. Any indicated studies should be performed. 3. Direct the claims file to a clinician to address the etiology of the Veteran’s foot disorder. The clinician is asked to provide an opinion as to whether it is at least as likely as not (50% probability or more) that the current foot disorder is related to active duty. The clinician is asked to specifically consider the multiple notations of heel pain in service, as well as the notation of plantar fasciitis during service. A thorough rationale is required for any opinion rendered. 4. Direct the claims file to a clinician to address the etiology of a GI disorder. The clinician is asked to provide an opinion as to whether it is at least as likely as not (50% probability or more) that a GI disorder, diagnosed as GERD, is related to active duty. The clinician is asked to specifically consider the reports of dysphagia and esophageal compaction during service and whether those findings are related to GERD. A thorough rationale is required for any opinion rendered. 5. Direct the claims file to a clinician to address the etiology of ED. The clinician is asked to provide an opinion as to whether it is at least as likely as not (50% probability or more) that ED is related to service or proximately due to, or aggravated beyond its natural progression by service-connected PTSD. A thorough rationale is required for any opinion rendered. CONTINUED ON NEXT PAGE   6. As to the claims for plantar fasciitis, GI, and ED, examinations are not required unless necessary in order to provide the requested opinions. L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Yacoub, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.